Sequential Free Flaps in Lower Extremity Reconstruction.
Research article published in JPRAS open (2025)
Abstract
INTRODUCTION: Sequential free flaps are often utilized for complex defects, particularly for recurrent head and neck tumors. However, their application in lower extremity (LE) reconstruction following trauma or oncology is less common. This study evaluated the indications, flap survival rates, and complications of sequential free flaps utilized in LE reconstruction. METHODS: Data from our multicenter database spanning from 2002 to 2020 were analyzed retrospectively through chart review. Adult patients who underwent sequential free flaps to the LE without complete initial flap loss were included. Outcome measures included ultimate flap viability and complications associated with sequential reconstructions. RESULTS: A total of 6 patients were identified: 2 patients (33%) required a second reconstruction following trauma, 1 patient (17%) following tumor recurrence, and 3 patients (50%) for chronic wounds related to infection. Most second free flaps survived (83%), with the exception of one in which the patient ultimately underwent a transfemoral amputation. Complications were observed in 3 patients (50%). CONCLUSION: The main indication for second free flap reconstruction in the LE is the failure of durable wound closure with the first reconstruction, despite the absence of flap loss. In these complex scenarios, it is often prudent to utilize preoperative vascular imaging and to use distinct recipient vessels from those used in the first flap. Overall, sequential free flaps can be used in complex cases of limb salvage; however, they are associated with a substantial risk of complications. LEVEL OF EVIDENCE: Therapeutic-IV.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Резюме
Sequential free flaps are often utilized for complex defects, particularly for recurrent head and neck tumors. However, their application in lower extremity (LE) reconstruction following trauma or oncology is less common.
Почему это важно для гирудотерапии
В данном ретроспективном многоцентровом исследовании оценивались показания, выживаемость лоскутов и осложнения при последовательных свободных лоскутах в реконструкции нижних конечностей; идентифицировано шесть пациентов со вторыми свободными лоскутами по поводу травмы, рецидива опухоли или хронических ран; выживаемость второго лоскута составила 83%, а частота осложнений — 50%. Работа имеет косвенное отношение к области ASH, поскольку сложная лоскутная реконструкция является клинической ситуацией, в которой медицинские пиявки иногда применяются в качестве вспомогательного средства при венозном застое. Однако в аннотации не упоминаются пиявки, гирудотерапия или спасение лоскута при венозном застое. Значимость исследования является косвенной, а само исследование ограничено очень малым размером выборки.
Цитирование
Связанный клинический контекст
Узнайте, как это исследование связано с клинической практикой
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